Ottawa pressures provinces on mental health

OTTAWA — Prime Minister Justin Trudeau is making a public plea to the provinces to take Ottawa up on its offer to spend more on mental health — even as federal officials were burning up the phone lines behind the scenes to negotiate health funding deals with individual provinces.

In Calgary to talk to business people Wednesday, Trudeau urged mental health advocates to pressure their provincial governments to work with Ottawa on mental health.

He said his government wants to pour “billions of dollars into improving mental health services and treatment” — money that is desperately needed not just to help those struggling with mental illness but to boost employee productivity in work places across the country.

“This is something that we are very, very serious about moving forward on. We’ve put historic amounts of money on the table. And we certainly hope that the provinces are going to realize that it’s time to invest,” Trudeau said.

On Monday, provinces and territories rejected a federal offer that would have poured an additional $25 billion over the next five years into health care, with a chunk of that specifically targeted for mental health and home care.

While that offer is now off the table and the federal government has given up hope of striking a national deal on health funding, federal officials say it’s still committed to making big investments in home care and mental health.

It is continuing to negotiate with individual provinces and territories — as many as five or six of which appear to be having second thoughts about walking away Monday from the federal offer.

Federal officials say the phone lines have been burning up since Monday as the reality sinks in that Finance Minister Bill Morneau wasn’t bluffing when he made the offer and advised provincial and territorial health and finance ministers that was as good as it was going to get.

The offer included boosting health transfer payments to provinces by 3.5 per cent a year, plus another $11 billion over 10 years for home care and mental health services and $544 million over five years for prescription drug and “innovation” initiatives.

Almost immediately after that offer was supposedly unanimously rejected, New Brunswick signalled that it was offside and would try to negotiate a bilateral deal with the federal government.

And now federal officials confirm as many as six provincial and territorial governments are contemplating doing the same.

While a national deal would have been the most straightforward way to ensure additional health funding would be included in Morneau’s second budget early in the new year, officials say there’s still potential for that to happen, although the path forward is now considerably more complicated.

The country’s leading mental health advocates say only seven per cent of the country’s health dollars go towards mental health.

The Mental Health Commission of Canada says the lack of attention to mental health issues costs the country about $50-billion a year in lost productivity.

Federal officials maintain the money offered Monday for improving mental health services would have been enough to ensure that every mentally ill Canadian under the age of 25 would be able to get the help they need, a view echoed Wednesday by the Mood Disorders Society of Canada.

The society encouraged the federal government to continue to champion a targeted $5-billion investment over 10 years to address in what it called “an epidemic affecting all Canadians.”

“Mental health issues affect all Canadians,” the society said in a statement. “Seventy per cent of adults living with a mental illness have onset before the age of 18. Early intervention would have an immediate positive impact on the health of our youth.

“Investing in mental health services early would lead to more rapid recovery and symptom management and would drastically reduce costs associated with chronic mental illness.”

However, the sticking point in Monday’s failed negotiations was not the federal offer of targeted funds for home care and mental health. Rather, it was the proposal to lock in the annual rate of increase in the federal health transfer payment at 3.5 per cent.

Since 2004, the transfer has increased at a rate of six per cent. The previous Conservative government unilaterally decided that as of 2017 that would drop to a rate of three per cent, or nominal growth in the economy, whichever is higher.

Ontario Premier Kathleen Wynne has said the Trudeau government’s offer of a locked in 3.5 per cent is even worse than what the Conservatives had planned.

Provincial and territorial governments have been pushing for an increase of at least 5.2 per cent each year, arguing that’s what’s required just to keep the lights on in the health system. Alternatively, they’ve asked that the six per cent increase remain in place for the coming year, during which they can continue negotiations with the federal government.

Federal officials say neither of those scenarios is in the cards. Nor is it likely that Trudeau will acquiesce to premiers’ demands for a first ministers meeting on the issue.